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| {{CMG}} | | __NOTOC__ |
| | {{DiseaseDisorder infobox | |
| | Name = Steatorrhea | |
| | ICD10 = {{ICD10|K|90|4|k|60}} | |
| | ICD9 = {{ICD9|579.8}} | |
| | ICDO = | |
| | Image = | |
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| | OMIM = | |
| | MedlinePlus = | |
| | DiseasesDB = |}} |
| | {{Steatorrhea}} |
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| | {{CMG}}; {{AE}} {{Vbe}} {{ADG}} |
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| | ==[[Steatorrhea overview|Overview]]== |
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| ==Overview== | | ==[[Steatorrhea historical perspective|Historical Perspective]]== |
| {{Search infobox}}
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| '''Steatorrhea''' is the formation of non-solid [[feces]]. Stools may also float due to excess fat from [[malabsorption]], have an oily appearance and be foul smelling. An oily anal leakage or some level of [[fecal incontinence]] may occur. There is increased [[fat]] excretion, which can be measured by determining the fecal fat level. While definitions have not been standardized, fat excretion in feces in excess of 0.3 (g/kg) / day is considered indicative of steatorrhea.
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| ==Possible biological causes== | | ==[[Steatorrhea classification|Classification]]== |
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| Possible biological causes can be lack of [[bile]] acids (due to liver damage or hypolipidemic drugs), defects in pancreatic juices (enzymes), and defective mucosal cells. The absence of bile acids will cause the feces to turn gray or pale.
| | ==[[Steatorrhea pathophysiology|Pathophysiology]]== |
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| ===Differential Diagnosis of Underlying Causes=== | | ==[[Steatorrhea causes|Causes]]== |
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| * [[malabsorption]], e.g. in [[inflammatory bowel disease]], [[coeliac disease]], and [[abetalipoproteinaemia]]
| | ==[[Steatorrhea differential diagnosis|Differentiating Steatorrhea from other Diseases]]== |
| * [[exocrine pancreatic insufficiency]]
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| * [[pancreatitis|chronic pancreatitis]]
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| * [[choledocholithiasis]] - (obstruction of the [[bile duct]] by a [[gallstone]])
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| * [[pancreatic cancer]] - (if it obstructs biliary outflow)
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| * [[primary sclerosing cholangitis]]
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| * [[bacterial overgrowth]]
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| * [[short bowel syndrome]]
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| * [[cystic fibrosis]]
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| * [[Zollinger-Ellison syndrome]]
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| * [[giardiasis]] - a protozoan parasite infection
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| * Abuse or misuse of certain prescribed slimming pills.
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| ==As a side effect== | | ==[[Steatorrhea epidemiology and demographics|Epidemiology and Demographics]]== |
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| Steatorrhea can also be due to eating non-digestible oils or fats such as [[Olestra]], and a side-effect of medicines that prevent the absorption of dietary fats such as [[Orlistat]],<ref name=WP>{{cite news |first= |last= |authorlink= |coauthors= |title=Weighing a Pill For Weight Loss |url=http://www.washingtonpost.com/wp-dyn/content/article/2006/01/23/AR2006012301270.html |quote=While the Food and Drug Administration (FDA) still must approve the switch, the agency often follows the advice of its experts. If it does, [[Orlistat]] (xenical) -- currently sold only by prescription -- could be available over-the-counter (OTC) later this year. But it's important to know that the weight loss that's typical for users of the drug -- 5 to 10 percent of total weight -- will be less than many dieters expect. And many consumers may be put off by the drug's significant gastrointestinal side effects, including [[flatulence]], [[diarrhea]] and anal leakage. |publisher=[[Washington Post]] |date= |accessdate=2007-07-06 }}</ref><ref name=CSPI>{{cite news |first= |last= |authorlink= |coauthors= |title= Frito-Lay Study: Olestra Causes "Anal Oil Leakage" |url=
| | ==[[Steatorrhea risk factors|Risk Factors]]== |
| http://www.cspinet.org/new/flaynal.html |quote=The Frito-Lay report states: "The anal oil leakage symptoms were observed in this study (3 to 9% incidence range above background), as well as other changes in elimination. ... Underwear spotting was statistically significant in one of two low level consumer groups at a 5% incidence above background." Despite those problems, the authors of the report concluded that olestra-containing snacks "should have a high potential for acceptance in the marketplace." |publisher=[[Center for Science in the Public Interest]] |date=Thursday, February 13, 1997 |accessdate=2007-07-07 }}</ref><ref name=NW>{{cite news |first= |last= |authorlink= |coauthors= |title=The Word Is 'Leakage'. Accidents may happen with a new OTC diet drug. |url=http://www.msnbc.msn.com/id/19263093/site/newsweek/ |quote=GlaxoSmithKline has a tip for people who decide to try Alli, the over-the-counter weight-loss drug it is launching with a multimillion-dollar advertising blitz—keep an extra pair of pants handy. That's because Alli, a lower-dose version of the prescription drug [[Xenical]], could (cue the late-night talk-show hosts) make you soil your pants. But while Alli's most troublesome side effect, anal leakage, is sure to be good for a few laughs, millions of people who are desperate to take off weight may still decide the threat of an accident is worth it. |publisher=Newsweek |date=June 25, 2007 |accessdate=2007-06-21 }}</ref><ref name=CSPI2/>
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| ===Artificial fats=== | | ==[[Steatorrhea screening|Screening]]== |
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| The fat substitute [[Olestra]], used in some reduced-fat foods, has been proven to cause leakage in some consumers. The United States [[Food and Drug Administration]] warning indicated that excessive consumption of Olestra could result in "loose stools"; this warning has not been required since 2003.<ref name=CSPI/><ref name=CSPI2> {{cite news |first= |last= |authorlink= |coauthors= |title=Reported medical side-effects of Olestra according to Procter and Gamble studies |url=http://www.cspinet.org/olestra/11cons.html |quote=Olestra sometimes causes underwear staining associated with "anal leakage." Olestra sometimes causes underwear staining. That phenomenon may be caused most commonly by greasy, hard-to-wipe-off fecal matter, but occasionally also from anal leakage (leakage of liquid olestra through the anal sphincter). |publisher=[[Center for Science in the Public Interest]]|date= |accessdate=2007-06-21 }}</ref>
| | ==[[Steatorrhea natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
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| ===Medications=== | | ==Diagnosis== |
| | | [[Steatorrhea history and symptoms|History and Symptoms]] | [[Steatorrhea physical examination|Physical Examination]] | [[Steatorrhea laboratory findings|Laboratory Findings]] | [[Steatorrhea electrocardiogram|Electrocardiogram]] | [[Steatorrhea x ray|X Ray]] | [[Steatorrhea CT|CT]] | [[Steatorrhea MRI|MRI]] | [[Steatorrhea ultrasound|Ultrasound]] | [[Steatorrhea other imaging findings|Other Imaging Findings]] | [[Steatorrhea other diagnostic studies|Other Diagnostic Studies]] |
| [[Orlistat]] (Xenical) is a diet pill that works by blocking the enzymes that digest fat. As a result fat cannot be absorbed from the gut and some fat is excreted in the feces instead of being metabolically digested, sometimes causing oily anal leakage.<ref name=WP/><ref name=NW/> | |
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| ===Natural fats===
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| Consuming Jojoba oil has been documented to cause steatorrhea and anal leakage because it is indigestible.<ref>[http://ajpregu.physiology.org/cgi/content/abstract/263/3/R464 Comparative aspects of lipid digestion and absorption: physiological correlates of wax ester digestion]</ref>
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| Consuming escolar and oilfish (sometimes called butterfish) will often cause steatorrhea. The fish is commonly used in party catering due to its delicate flavor and the fact that it is cheap and readily available.
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| ==Treatment== | | ==Treatment== |
| | [[Steatorrhea medical therapy|Medical Therapy]] | [[Steatorrhea surgery|Surgery]] | [[Steatorrhea primary prevention|Primary Prevention]] | [[Steatorrhea secondary prevention|Secondary Prevention]] | [[Steatorrhea cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Steatorrhea future or investigational therapies|Future or Investigational Therapies]] |
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| Generally steatorrhea can be treated with prescription medicine and healthy diet. Performance status is often used as a measure to determine whether a patient can receive treatment, or whether dose reduction is required.
| | ==Case Studies== |
| | | [[Steatorrhea case study one|Case #1]] |
| ==References== | |
| {{reflist|2}}
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| | [[Category:Gastroenterology]] |
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| [[Category:Gastroenterology]]
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| [[Category:Conditions diagnosed by stool test]]
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| [[de:Steatorrhoe]]
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| [[fr:Stéatorrhée]] | | [[fr:Stéatorrhée]] |
| [[it:Steatorrea]]
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| [[nl:Steatorroe]]
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| [[pt:Esteatorreia]] | | [[pt:Esteatorreia]] |
| [[sv:Steatorré]]
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